Implementing an Antepartum Epilepsy Monitoring Unit

Sunday, June 16, 2013

Title: Implementing an Antepartum Epilepsy Monitoring Unit

Ryman Hall B4 (Gaylord Opryland)
Leslie Diane Spagnol, MSN, RNC , High Risk Antepartum Unit, Magee-Womens Hospital of UPMC, Pittsburgh, PA
Joyce A. Thompson, MS, BSN, RNC , Obstetrical Division, Magee Womens Hospital, Pittsburgh, PA
Janice Buys, RN-C, BSN, BSBA , Obstetrical Division, Magee Womens Hospital, Pittsburgh, PA
Kelly Martin, RN, BSN , Obstetrical Division, Magee Womens Hospital, Pittsburgh, PA

Discipline: Advanced Practice (AP), Childbearing (CB), Women’s Health (WH)

Learning Objectives:
  1. Epilepsy medications can affect the antepartum patient and her newborn.
  2. Define epilepsy monitoring and it's development on a high risk antepartum unit.
  3. Define the positive affects of intensive epilepsy monitoring during the antepartum period and post birth.
Submission Description:
Purpose for the program:

The purpose of the Epilepsy Monitoring Unit is to provide a safe environment for pregnant women on tetragenic anti-epilepsy drugs (AEDs) and research the maternal fetal effects while doing so. In the United States, there are 3-5 births per thousand women who have a form of epilepsy. Many of these women are taking class D in pregnancy AEDs. When clinically advantageous to convert those taking class D AEDs to an AED with less fetal affects it is done so in a controlled environment.

Proposed change:

Research does indicate that AED drug conversion is done best in a monitored environement. The additional of continuous fetal monitoring provides invaluable clinical information on fetal satus while doing.

Implementation, outcomes and evaluation:

The clinical team has established an multi-disciplinary group consisting of neurology, maternal fetal medicine, nursing and administrative leadership to build the physical environment, identify training needs and form policies, procedures and best practices. The Epilepsy Monitoring Unit is newly developed and ongoing evaluation is taking place. 

Implications for nursing practice:

Knowledge for the clinical team has been broadened to include epilepsy in pregnancy, seizure management and side effects of AED drugs. Successful outcomes have already been achieved in a safe environment which provides a model for other healthcare facilities.

Keywords: Epilepsy Monitoring Unit, Epilepsy in Pregancy